Challenges and Opportunities for Physiologically Controlled Therapy in Neural Systems

Brain Stimulation Technology for the treatment of neurological disorders is rapidly evolving. With the advent of “bidirectional” systems, such as the Medtronic Percept, which are able to sense from and stimulate the brain simultaneously, there is opportunity to modify stimulation based on changes in brain activity. The utility of such a bidirectional application is exemplified by the success of the NeuroPace responsive neuro stimulation (RNS) device in the reduction of seizures [1] and pivotal trials of spinal cord stimulation for chronic leg pain using evoked compound action potentials to facilitate a homeostatic feedback system [2] .